Thursday, 13 November 2014

Scalpel please

I’ve managed to drag myself out of the docetaxel induced
illness stupor I’ve been in for the last week to write about my visit to see my
surgeon last Friday. I’ve been feeling quite useless this week having done
nothing of any value apart from sleep and have the occasional hot bath so I’m
hoping writing this post will at least go part way to rectifying that. Feeling
useless seems to be par for the course for me at the moment, but that’s
another blog post….

Anyway, last Friday I went to meet my surgeon to discuss
plans for the new year. Not which festivity we’ll be at to see it in sadly, but
rather which bits of my body he was looking to remove in January. The first
time I met him was when I was coming round from a general anesthetic, looking
like a smurf after being injected with blue dye and having five lymph nodes
removed. As usual, I was the youngest in the waiting room at the breast clinic
by at least 20 years. Cue stares of confusion and puzzlement, particularly when
I am called in to the consultation room rather than my elderly relative walk out of it.

The reason that I have been given chemotherapy first is to
try and shrink the tumour down so that it can be removed with a lumpectomy
rather than a mastectomy. As I am not exactly blessed in the boob department,
removing the lump without shrinking it would have left me with what could
probably be described as a mangled tit. However, after lots of reading and
researching, I have begun to think that a lumpectomy is not for me – rather I
would just get rid of both of the buggers to try and give myself the best
possible chance of not having another primary breast cancer.‘But that’s such a big decision and so
traumatic!’ I hear you cry. Yes it is – but do you know what is more traumatic?
Having breast cancer. Believe me, I know. A double mastectomy doesn’t remove
the risk entirely but it certainly reduces it.

However, this isn’t an operation that NHS doctors tend to do
simply on request. As my GP put it, doctors are trained to make people better –
to remove bad tissue and leave the good stuff. To remove healthy tissue with no
obvious reason goes against the conventional doctor’s way of thinking.

I went to see the surgeon, struggling with the unpleasant beginnings of tax
side effects, almost prepared for a bit of a fight. I wanted to ask for a
referral for genetic testing purely based on my age. I have no strong family
history of breast cancer – my paternal grandmother possibly had it in her 80s
however certainly didn’t’ die from it. My tumour also doesn't have the characteristics that can indicate a BRCA 1 gene fault – triple negative and very fast
growing (grade 3). However, the simple fact is that I am 32 and I have breast
cancer. That in itself is very unusual and for my own piece of mind I need to know
whether it is due to a gene fault. Then I can take whatever steps are needed to
reduce any further risk of another primary breast cancer or other related
cancers.

However, surprisingly the surgeon agreed with everything I
said and confirmed he would put me on a quick referral to genetics as the
result of the testing would determine the type of surgery I have in early
January. For the first time, I felt like someone in the medical profession was
treating me as a younger woman with breast cancer, rather than a woman with breast
cancer. If that makes any sense at all. He also told me that in dimension terms, my tumour had shrunk by almost half and that a lot of what I could feel now was probably scar tissue, formed when cancer cells die. Pow - take that you bastards!!

So to the surgery and which bits of me will be no more come
January. Basically, if genetic testing shows I do have a gene fault it’ll be a double
mastectomy, one at a time. I’ll have the bad one off first, with delayed reconstruction
as I’ll need to have radiotherapy. Then when they come to reconstruct the bad
side, they’ll also take the good one off and reconstruct that one immediately.
It does mean I’ll be a one- titted wonder for six to twelve months but I can
cope with that. I’m not exactly Katie Price in the boob stakes – it’s nothing
that a good prosthesis and a bit of padding won’t fix. Getting naked in front
of a new fella (wishful thinking here) might be a bit weird but to be
honest, if one temporarily absent boob puts him off he’s not the one for me.
Amright, ladies??

Anyway, if there isn’t a gene fault, but the genetics team
say I am at increased risk of another primary breast cancer due to my age, the
same surgery can still be done, it’s just that ‘there are a few more hoops to
jump through’ as my surgeon put it. One of these being me seeing a psychologist
to ensure that my fears about having breast cancer again are likely to be
reduced by having a double mastectomy. No point whacking them both off if I’m
still going to be panicking about it is there? However, I don’t think anything
ever ensures that the fear leaves you entirely. As one woman who is now three
years from her diagnosis said to me – it never goes away; it just gets easier
to deal with.

I’ll also need a level two node clearance , as my sentinel node biopsy showed one node out of five removed involved. A level two clearance
basically means taking all the nodes out from under your arm up to your chest.
To be honest, this scares me more than the removal of my actual boob.

So basically, the outcome of my genetics referral will ultimately
determine the surgery that I have. As regards the type of reconstruction, this
is totally way over my head so I’m being referred to discuss this with the
plastic surgeons. However, if I lose my nipples. I have decided I want roses
tattooed on instead or maybe hearts. Or even the Chuckle Brothers.

I still may be able to have a lumpectomy, but if not, do I
feel sad about the potential loss of my boobs? To a degree, yes. I’ll lose a
part of me and probably end up with a pair of foobs with no feeling in them
that someone could set fire to and I wouldn’t notice. My boobs used to be one
of my favourite parts of my body – until one of them tried to kill me that is.
So you could say my relationship with them is not the best right now. We’ve
fallen out big time. It’ll take me a while to forgive them- well, one of them anyway. So I won’t be too
sad to see them go. But if I do have to say bye bye to my boobs or tara to my
tits, I’m going to give them a good send off - a party with bubbly, cake and balloons. And guess what the theme will be.....?